NRA Wins Again

Dateline: 6/24/15 – The House Appropriations Committee GOP Panel Votes to Keep Funding Ban for Gun Violence Research.

A GOP-led panel blocked a proposal Wednesday that would have reversed a nearly 20-year-old ban on funding for the Centers for Disease Control and Prevention (CDC) to research on gun violence.

The House Appropriations Committee voted 32-19 against ranking member Rep. Nita Lowey’s (D-N.Y.) amendment to a bill that would fund health, education and labor programs in the next fiscal year.

“When it comes to gun violence, my friends, this committee won’t give one dime for the CDC to conduct research on something that is killing Americans by the thousands,” Lowey said.

The issue of gun control was once again, and predictably, raised last week after the massacre in Charleston.  The arguments don’t change.  The positions of groups and individuals don’t change.  Everybody cites whatever facts they have handy to support their belief; be it that “guns don’t kill; people kill” or “guns increase homicides.”  At this time, the former group has better facts on their side because although the number of guns in the US has increased, there’s general statistical agreement that the per capita gun homicide rate has declined (Pew Research).  Significantly from a high of 7.0 in 1993 to a low of 3.6 in 2010.  Still extremely high by western industrialized nations standards but a significant improvement. Not that anyone can explain the drop.
While that Pew report is consistent with other reports on gun homicides, the numbers shown for “non-fatal violent firearm crime” are dubious.  Last week, I asked what seemed to me to be a simple question: on an annual basis, how many people incur non-fatal gunshot wounds?

IOW has the rate of gun homicides gone down because fewer people are shot or because trauma medical care for gunshot victims improved?  Or some combination of the two.   And how much does all that medical care cost the US health care “system?”
It wasn’t difficult to find numerous reports that seemed to address those questions.  And yet, it became quickly apparent to me that they were all based on estimates and not actual data.  The only honest investigative report on this was done by ProPublica: Why Don’t We Know How Many People Are Shot Each Year in America?

How many Americans have been shot over the past 10 years? No one really knows. We don’t even know if the number of people shot annually has gone up or down over that time.

The government’s own numbers seem to conflict. One source of data on shooting victims suggests that gun-related violence has been declining for years, while another government estimate actually shows an increase in the number of people who have been shot. Each estimate is based on limited, incomplete data. Not even the FBI tracks the total number of nonfatal gunshot wounds.

While the number of gun murders has decreased in recent years, there’s debate over whether this reflects a drop in the total number of shootings, or an improvement in how many lives emergency room doctors can save.

Meanwhile, the CDC numbers are based on a representative sample of 63 hospitals nationwide, and the margin of error for each estimate is very large. The CDC’s best guess for the number of nonfatal intentional shootings in 2012 is somewhere between 27,000 and 91,000.

The FBI also gathers data on gun crime from local police departments, but most departments do not track the number of people who are shot and survive. Instead, shootings are counted as part of the broader category of “aggravated assault,” which includes a range of gun-related crimes, from waving a gun at threateningly to actually shooting someone.
There were about 140,000 firearm aggravated assaults nationwide in 2012, according to the FBI’s report. How many of those assaults represent someone actually getting shot? There’s no way to tell.

How can we begin to address an issue that’s as controversial and complicated as gun violence if we don’t even have the tangible facts?  Facts that aren’t subject to argumentation by any side of the debate.  The public doesn’t object to mandatory reporting of diseases to the CDC.  We demand it and are quick to blame the CDC and hospitals if they aren’t immediately on top of an occurrence of an unexpected and rare disease.  (Reference Ebola in one hospital last year and the collective freak out in the country.)    There aren’t any great impediments to instituting mandatory reporting of gunshot wounds to the CDC by medical professionals.  Not even necessary for those professionals to determine if the victims were intentionally or accidentally shot.  Sampling and statistics can provide a good enough answer to the intentional and accidental rates as well as the severity of the injuries.

Is there some number of annual non-fatal gunshot victims and average medical cost per victim that would make a difference in the opinions of Americans on guns?  (The occasional mass killings and over 11,000 gun homicides per year must be tolerable since it doesn’t lead to public demands for changes.)  They had no difficulty coming up with a number of military deaths in Iraq that they thought would be acceptable, approximately 5,000, and the US military made sure that it came in right around that number.  What’s the tolerance for the number of gunshot victims?  And cost (a question wrt Iraq that Americans weren’t asked and didn’t bother to think about).   Nobody knows the answer to that either.  (The tolerance level for both for the majority are likely much higher than gun control advocates want to believe.)

With each mass killing that commands national attention, we continue our verbal shots in the dark.  No more informed than we were with the last tragic event.  And so it goes.